title: Maternal red blood cell alloimmunisation in south western Uganda.
abstract: OBJECTIVE
  To identify the frequency and nature of maternal red blood cell (RBC) alloimmunisation in Uganda and to determine the prevalence of RhD negativity and the rate of RBC alloimmunisation in Ugandan pregnant women.
  
  
  BACKGROUND
  Haemolytic disease of the foetus and newborn (HDFN) results from maternal alloimmunisation following exposure to allogeneic RBCs during pregnancy or blood transfusion. The prevalence of maternal RBC alloimmunisation in Ugandans is not known.
  
  
  METHODS
  Pregnant women at Mbarara Hospital, South Western Uganda, were investigated in a cross-sectional study. Demographics, transfusion and obstetric histories were recorded. Maternal RBC alloimmunisation was demonstrated using immunohaematological techniques.
  
  
  RESULTS
  A total of 2001 pregnant women were recruited; 3.6% of them being RhD negative. Forty-five women (2.2%; 95% CI: 1.6-2.9) were found to be alloimmunised to RBC antigens. There were 38 RBC alloantibodies of known specificity including anti-S, 12; anti-M, 11; anti-Le(a) , 6; anti-D, 4 and 1 each of anti-K, anti-Fy(b) , anti-Jk(a) , anti-Lu(a) and anti-Kp(a) . In two women (4.4%), there were antibody combinations (anti-M+S and anti-K+Kp(a) ). Obstetric history, gestational age and previous immunising events were not significantly associated with the rate of alloimmunisation.
  
  
  CONCLUSIONS
  This study revealed a maternal RBC alloimmunisation rate of 2.2% which was comparable with findings from a Zimbabwean study where the prevalence was 1.7%. Given the 6·0% prevalence of anti-D among RhD-negative women in our study and the high immunogenicity of the D antigen, programmes for preventing anti-D alloimmunisation and HDFN in Uganda should be considered seriously.
authors.affiliation: Department of Haematology and Transfusion Medicine, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda. bn0012@yahoo.co.uk
authors.forename: B
authors.initials: B
authors.lastname: Natukunda
authors.forename: G
authors.initials: G
authors.lastname: Mugyenyi
authors.forename: A
authors.initials: A
authors.lastname: Brand
authors.forename: H
authors.initials: H
authors.lastname: Schonewille
mesh_terms: D000293:Adolescent; D000328:Adult; D004899:Erythroblastosis, Fetal / Q000453:epidemiology* / Q000276:immunology; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D005331:Fetomaternal Transfusion / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012203:Rh Isoimmunization / Q000453:epidemiology* / Q000276:immunology; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D014454:Uganda / Q000453:epidemiology
chemical_list: D012204:Rh-Hr Blood-Group System; C026410:Rho(D) antigen